Risk factors of failed observational treatment of traumatic hemothorax

Chinese Journal of Thoracic and Cardiovaescular Surgery Pub Date : 2020-01-25 DOI:10.3760/CMA.J.ISSN.1001-4497.2020.01.006

Shaowei Xin, Tao Wang, Xiangbing Xin, Yongchao Han

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Abstract

Objective To identify the risk factors of failed observational treatment of traumatic hemothorax. Methods Clinical data of traumatic hemothorax combined with observational treatment were selected from the data of chest trauma cases admitted to the thoracic surgery department from January 2012 to December 2018. The treatment effect was analyzed, and the risk factors of failed observational treatment were analyzed by multivariate analysis. Results The total failure rate of observational treatment was 59.26%(32/54), and the details of hemothorax volume, length of stay in hospital, pneumothorax and patients with more than 3 rib fractures in the failed conservative treatment group were more than those in the successful treatment group(P<0.05). Independent risk factors of failed observational treatment were more than 3 rib fractures(OR=5.535, 95%CI: 1.065-28.754, P=0.042)and pneumothorax(OR=9.529, 95%CI: 1.988-45.580, P=0.005). Conclusion Pneumothorax and more than 3 rib fractures are the independent risk factors of failed observational treatment, and should be included in the observational treatment decision of traumatic hemothorax. Key words: Hemothorax; Thoracic trauma; Rib fracture

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外伤性血胸观察治疗失败的危险因素

目的探讨外伤性血胸观察治疗失败的危险因素。方法选取2012年1月至2018年12月胸外科收治的创伤性胸外伤患者的临床资料，并结合观察治疗。对治疗效果进行分析，并对观察治疗失败的危险因素进行多因素分析。结果观察治疗总失败率为59.26%(32/54)，保守治疗失败组的血胸体积、住院时间、气胸及3根以上肋骨骨折患者的详细情况均多于治疗成功组(P<0.05)。观察性治疗失败的独立危险因素为3处以上肋骨骨折(OR=5.535, 95%CI: 1.065 ~ 28.754, P=0.042)和气胸(OR=9.529, 95%CI: 1.988 ~ 45.580, P=0.005)。结论气胸及3处以上肋骨骨折是观察治疗失败的独立危险因素，应纳入外伤性血胸观察治疗决策。关键词:血胸;胸外伤;肋骨骨折

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Chinese Journal of Thoracic and Cardiovaescular Surgery

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